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https://doi.org/10.24869/spsih.2026.312

Is Lithium the “Culprit”? – A Case Report of a Patient With Comorbid Bipolar Affective Disorder and Hashimoto Thyroiditis

Jelena Rebić ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet Sveučilišta u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska *
Tanja Grahovac Juretić ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet Sveučilišta u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska
Marina Letica Crepulja ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet Sveučilišta u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska
Elizabeta Dadić-Hero ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska; Katedra za socijalnu medicinu i epidemiologiju, Medicinski fakultet Sveučilišta u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska
Radmila Rebić ; Nastavni Zavod za javno zdravstvo Primorsko-goranske županije, Krešimirova 52a, 51000 Rijeka, Hrvatska

* Dopisni autor.

Sažetak

It has been demonstrated that patients with bipolar
affective disorder (BAD) more often suffer
from inflammatory and autoimmune (AI) diseases,
and one of the most common AI conditions in
this patient population is Hashimoto’s thyroiditis.
This is a condition in which the immune system
“attacks” thyroid tissue, gradually leading to
its damage and dysfunction (most often reduced function), frequently with a consequent adverse
impact on mental health as well. In patients with
BAD, Hashimoto’s thyroiditis can destabilize the
mental state and also complicate the treatment
of BAD, especially because many mood stabilizers,
including lithium, are associated with thyroid
disorders. Therefore, in treating individuals with
comorbid BAD and Hashimoto’s thyroiditis, an
interdisciplinary approach is important, namely
cooperation between the psychiatrist and endocrinologist,
in order to achieve stability of both
mental and physical health. We present the case
of a younger female patient with comorbidity of
these conditions. After the diagnosis of thyroiditis,
the patient and her family insisted on discontinuing
lithium from the treatment regimen.
Almost a year after discontinuation of this drug,
anti‑TPO antibodies (specific for AI thyroid diseases)
remain markedly elevated (even twice as
high as values measured during lithium therapy),
while thyroid hormones are, for now, within normal
limits. In this case, the question arises as to
whether lithium influenced the development of
AI thyroiditis, or whether the decisive factor is
the pre‑existing hereditary burden for thyroid
disease.

Ključne riječi

bipolar affective disorder (BAD); autoimmune diseases; Hashimoto’s thyroiditis; lithium; interdisciplinary approach

Hrčak ID:

353010

URI

https://hrcak.srce.hr/353010

Datum izdavanja:

15.6.2026.

Podaci na drugim jezicima: hrvatski

Posjeta: 0 *